After years of yo-yo dieting, that familiar and potentially dangerous cycle of losing weight and gaining it back, accounting professor Roger Gee was ready to give up on permanently shedding some of his 321 pounds.

TEAMING UP FOR HEALTH - College accounting professor Roger Gee credits a health coach with helping him shed nearly 75 pounds. The role of a coach can range from helping a client remember to take medicine properly to helping with significant medical care decisions. CNS Photo by Eduardo Contreras.

Then his health insurer offered a new option. Gee could team up with a health coach, a specially trained health professional who would help him develop better eating habits, an exercise routine and a new outlook tied to his desire to live healthier and longer.

The Southern California professor was skeptical at first. "I had been through other weight loss programs, and as soon as I stopped using their products I put the weight right back on," he said. "My fear was that that was going to happen again."

But this time it worked.

Gee lost nearly 75 pounds over the next year and a half, and kept it off. He started wearing clothes that hadn't fit in more than a decade. Perhaps more significantly, he underwent a necessary surgery that doctors say he likely wouldn't have survived had he not lost the weight.

Health coaching is spreading as a growing number of companies and insurers try to play a more active role in helping their workers and members stay healthy and better manage chronic diseases such as diabetes and hypertension.

Health coaching services are typically provided on a voluntary basis through health insurance plans. Nearly all of the interaction between coach and client happens over the telephone. The coach's role can range from the mundane - helping a client remember to take medicine properly or keep appointments with doctors - to the more weighty, such as answering questions about insurance benefits or helping with a medical care decision.

About 44 percent of the nation's largest companies offer health coaches to their employees, according to a survey released in March by the National Business Group on Health, a nonprofit group that represents large employers.

The effort could save money by keeping people off medications and out of hospitals.

Many coaching programs focus on smoking and obesity, risk factors that contribute to chronic diseases such as emphysema and diabetes.

Between 1997 and 2001, U.S. medical costs directly related to smoking totaled $75 billion, according to the national Centers for Disease Control and Prevention. Medical costs related to diabetes were $92 billion in 2002, according to the American Diabetes Association.

The San Diego County Voluntary Employee Benefits Association, which manages health insurance programs for Mesa College, where Gee teaches, and other San Diego schools, started offering health coaching services about two years ago on a voluntary basis to a limited number of members with chronic health conditions.

The service costs the association about $800 a year for each worker who uses it, but it should produce enough savings to help slow fast-rising insurance rates, said Nancy White, director of the group's health advocacy program.

"It's not a cookie-cutter approach like so many other (wellness) programs," White said. "It's one-on-one. That's what we like about it."

Health coaches are usually medical professionals with previous work experience as nurses, dietitians, physician assistants or personal trainers. They do most of their work over the telephone or online with clients who are assigned to them long term. In practice, health coaches often play the role of motivator, cheerleader and educator, said Elizabeth Thompson, who works as a health coach for American Specialty Health of San Diego.

"If you connect on a personal level with (a client) where your role is simply to engage them in their hopes and dreams for themselves and their health, that's a powerful tool," Thompson said. "Everyone wants to be heard and acknowledged."

American Specialty provides personal health improvement programs to insurers and employers around the country.

Insurer HealthNet offers health coaches 24 hours a day to its 1.5 million members in California, said Lance Lang, vice president and senior medical director. The service has helped reduce hospital admissions 18 percent among members with chronic diseases who use the service. A recent HealthNet survey indicated that most doctors like the service because coached patients tend to be better informed about their health and more helpful to their physicians, Lang said.

Nearly seven months after Gee's health coach program ended, the Mesa College professor has managed to kept off all the weight he lost. He still walks or goes to the gym every day and he cooks most of his meals at home.

Gee summed up his experience using a health coach in an evaluation he composed after completing the program. "For years I had turned a deaf ear to the suggestions that I eat less and exercise more to lose weight," he wrote. "My wife, my children and even my doctor had given up on me. I was afraid of dying too young to enjoy my family, especially my grandchildren, and to see the world with my wife.

"So far on this journey, I have lost 73 pounds. The most important impact on my health status, however, is that I am alive."

Copley News Service

What's a health coach?

Their roles can vary, but these are some of the things a health coach helps clients with:

- Evaluate their current health status.

- Identify health risks such as high blood pressure.

- Create health goals such as losing weight, running a marathon or playing more with their grandchildren.